ISSN:0361-1817    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Asthma is a chronic respiratory disease characterized by smooth-muscle constriction of the airway, bronchial hyperresponsiveness, and an ongoing inflammatory process. Although more common in children, asthma in adults also requires careful management to decrease morbidity and mortality. The majority of chronic asthma cases have an allergic component; therefore, efforts to identify and eliminate environmental triggers may decrease the symptoms of most asthmatics. Asthma-education programs based on patient self-management have been shown to decrease asthma morbidity. Mastery of the following topics is necessary for patient self-management: identifying and avoiding exposure to symptom precipitators, using prescribed medications correctly, managing medication side effects, and recognizing and responding to exacerbations. Advances in diagnostic and treatment modalities include the home use of peak-flow meters to monitor respiratory function, and the use of metered-dose inhalers and spacers for the delivery of inhaled medication. Inhaled beta-adrenergic agonists, administered in higher than usual doses, have become the bronchodilators of choice in the treatment of acute asthma. Studies have demonstrated that metered-dose inhalers can be used for this purpose, even with severe asthma attacks that require hospitalization. Systemic corticosteroids are also important in the management of acute attacks. Care providers who teach patients about common symptom triggers and encourage avoidance techniques, who employ current strategies to enhance patients' medication use and patients' recognition of exacerbations, and who incorporate up-to-date treatment plans for acute asthma attacks may help reverse distressing trends in asthma morbidity and mortality.

ISSN:0361-1817    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Asthma involves bronchoconstrictor mechanisms, possible abnormalities of airway smooth muscles and an inflammatory response. Past emphasis on bronchodilator therapy ignored the underlying inflammatory response. Since chronic asthma can eventually lead to irreversible airflow obstruction from uncontrolled inflammation, current drug therapy stresses both inflammation reduction and. bronchodilatation. This article discusses the rationale of current pharmacologic management for the adult client with chronic asthma and presents a step-care approach for management of the disease. Inhaled beta-agonists — effective bronchodilators — are the primary drug of choice. Steroids administered via inhalation are the most effective anti-inflammatory agents available. Cromolyn sodium is useful for prophylactic management of asthma. Theophyllinc, previously the cornerstone of asthma treatment, is now introduced later in the therapeutic plan as an additional bronchodilator. Inhaled anticholinergies may be tried as adjunctive asthma treatment. With careful assessment, intervention and management, health care providers can successfully care for most adult clients with chronic asthma.

ISSN:0361-1817    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Little has been accomplished over the last 20 years to help free the elderly from restraints, either physical I mechanical restraints or chemical. The nation's legal and health care systems encourage restraint of the elderly for their “safety,” while simultaneously limiting their autonomy, independence and mobility. This article reviews pertinent research carried out on the use of restraints, addresses the legal and ethical aspects of restraints, arid discusses the psychological and physical consequences related to their use. Alternative health care actions are suggested in place of the use of restraints.

ISSN:0361-1817    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Abortion has been a hotly contested political issue since the mid 1960s, when states began liberalizing their abortion laws. Recent Supreme Court rulings, such as Rust vs. Sullivan, the retirement of two liberal Supreme Court justices and the battle over Louisiana's abortion legislation have created new fervor on both fronts of the battle. All health care providers who care for women need to be cognizant of the current abortion laws and the factors that influence the abortion decision. These factors include the different levels of health risk and financial implications posed by continued pregnancy or abortion. Historically, numerous court cases have influenced women's health care, and reviews of several significant cases are provided. The Webster vs. Reproductive Health Services decision was the first case that directly challenged the Roe vs. Wade decision. The Webster decision enables states to have greater authority in writing their own abortion laws. Individual state laws can vary greatly, so it is vitally important for providers to know and understand the laws of their state.

ISSN:0361-1817    

出版商:OVID    

年代:1991

数据来源: OVID